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Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients.
Nutrients. 2022 Sep 28; 14(19)N

Abstract

Background: Rigid dietary controls and pill burden make a very-low protein (0.3−0.4 g/kg body weight per day), vegetarian diet supplemented with ketoanalogues of amino acids (sVLPD) hard to follow in the long-term. This study aimed to evaluate whether a ketoanalogue supplemental low-protein diet (sLPD) (0.6 g/kg body weight per day) could also reduce the risks of dialysis among CKD stage 4 patients. Methods: Patients aged >20 years with a diagnosis of stage 4 CKD who subsequently received ketosteril treatment, which is the most commonly used ketoanalogue of essential amino acids, between 2003 and 2018 were identified from the Chang Gung Research Database (CGRD). Then, these individuals were divided into two groups according to the continuation of ketosteril for more than three months or not. The primary outcome was ESKD requiring maintenance dialysis. Results: With one-year follow-up, the continuation group (n = 303) exhibited a significantly lower incidence of new-onset end-stage kidney disease (ESKD) requiring maintenance dialysis (6.8% vs. 10.4%, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41−0.94) in comparison to the discontinuation group (n = 238). Conclusions: This study demonstrated that initiating sLPDs since CKD stage 4 may additionally reduce the short-term risks of commencing dialysis without increasing CV events, infections, or mortality.

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Authors+Show Affiliations

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

MeSH

Amino AcidsAmino Acids, EssentialBody WeightDiet, Protein-RestrictedHumansKidney Failure, ChronicRenal DialysisRenal Insufficiency, Chronic

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36235673

Citation

Yen, Chieh-Li, et al. "Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis Among CKD Stage 4 Patients." Nutrients, vol. 14, no. 19, 2022.

Yen CL, Fan PC, Chen JJ, et al. Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients. Nutrients. 2022;14(19).

Yen, C. L., Fan, P. C., Chen, J. J., Kuo, G., Hsiao, C. C., Chen, C. Y., Tu, Y. R., Hsu, H. H., Chen, Y. C., & Chang, C. H. (2022). Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients. Nutrients, 14(19). https://doi.org/10.3390/nu14194020

Yen CL, et al. Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis Among CKD Stage 4 Patients. Nutrients. 2022 Sep 28;14(19) PubMed PMID: 36235673.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients. AU - Yen,Chieh-Li, AU - Fan,Pei-Chun, AU - Chen,Jia-Jin, AU - Kuo,George, AU - Hsiao,Ching-Chung, AU - Chen,Chao-Yu, AU - Tu,Yi-Ran, AU - Hsu,Hsiang-Hao, AU - Chen,Yung-Chang, AU - Chang,Chih-Hsiang, Y1 - 2022/09/28/ PY - 2022/08/24/received PY - 2022/09/21/revised PY - 2022/09/23/accepted PY - 2022/10/14/entrez PY - 2022/10/15/pubmed PY - 2022/10/18/medline KW - CKD KW - ESKD KW - dietary therapy KW - ketosteril KW - low protein diet JF - Nutrients JO - Nutrients VL - 14 IS - 19 N2 - Background: Rigid dietary controls and pill burden make a very-low protein (0.3−0.4 g/kg body weight per day), vegetarian diet supplemented with ketoanalogues of amino acids (sVLPD) hard to follow in the long-term. This study aimed to evaluate whether a ketoanalogue supplemental low-protein diet (sLPD) (0.6 g/kg body weight per day) could also reduce the risks of dialysis among CKD stage 4 patients. Methods: Patients aged >20 years with a diagnosis of stage 4 CKD who subsequently received ketosteril treatment, which is the most commonly used ketoanalogue of essential amino acids, between 2003 and 2018 were identified from the Chang Gung Research Database (CGRD). Then, these individuals were divided into two groups according to the continuation of ketosteril for more than three months or not. The primary outcome was ESKD requiring maintenance dialysis. Results: With one-year follow-up, the continuation group (n = 303) exhibited a significantly lower incidence of new-onset end-stage kidney disease (ESKD) requiring maintenance dialysis (6.8% vs. 10.4%, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41−0.94) in comparison to the discontinuation group (n = 238). Conclusions: This study demonstrated that initiating sLPDs since CKD stage 4 may additionally reduce the short-term risks of commencing dialysis without increasing CV events, infections, or mortality. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/36235673/Ketoanalogues_Supplemental_Low_Protein_Diet_Safely_Decreases_Short_Term_Risk_of_Dialysis_among_CKD_Stage_4_Patients_ DB - PRIME DP - Unbound Medicine ER -